More than half of the Kashmiri population is under the age of 18, and yet no exclusive pediatric hospital exists in Kashmir. Syed Asma puts the appalling situation of G B Pant Cantonment Hospital under the microscope.
It stinks! The pungent smell is unbearable. As one looks around for the source of this odor, an uncovered manhole catches the eye. Beside it is a small pile of sewage, which once blocked the drain and had now been removed. The contaminated water from the drain had overflowed, accumulated, and enveloped the entire area in a suffocating stench. “So, the sea [of this sewage water] is drying up. That’s good! ”says a man who is passing by.
He quickly walks past the scene and sits with two women and a child on a pavement, and joins them for lunch. This family is from Kupwara, and their six-year-old child is admitted in the Government GB Pant Cantonment General Hospital. The pavement on which they are having lunch is part of the hospital compound. After having lunch, the family packed their belongings and went inside the hospital, leaving behind leftovers and trash.
Sometime later,the pavement is clean again. A dog from the nearby garbage dump lying in the hospital had found his lunch in the Kupwara family’s leftovers. Dogs, rats and childrenare seen in almost similar proportions in the hospital, says an attendant, whose two-year-old daughter is admitted here for last two weeks. He is from Kellar, Pulwama. His daughter has a chest infection, he says.
He had visited a few doctors in his district hospitalbut they referred him to Srinagar.
Animals in the hospital have become problematic for both patients and attendants. “Last night when it was dark, I went outside to purchase medicine for my child. I stumbled over something and when it barked, I realized it was a dog. It was about to bite me,” says Abdul Rashid of Anantnag. “What would I have done if Aaqib (his four-year-old son) was with me? This question has been haunting me since then.”
One of the obvious reasons that the stray dogs continue to hover around the hospital is the garbage dumped in its premise. It is what feeds them. Maintaining the hospital’s overall hygiene is the responsibility of the army cantonment employees. “It is done once or may be twice in a day which is not sufficient,” says an official in the hospital.
Lack of sanitation has also led to the presence of rats in the wards. It is irksome for patients and attendants. “Last night our ward was awake as the rats in here were jumping from one bed to another and we had no nursing staff available here for help”, says Shaheen, whose three-month-old daughter has been admitted in the hospital for the past three days.
In light of this situation, the hospital’s administration hired an individual named Khurshid Ahmed Mir to check the number of unfriendly species in the hospital. In March, Mir had proposed a plan which could help decrease the number of dogs in the city. His proposal does not seem to be gaining traction any time soon, but he has been appointed to check the number of rats in the government hospital. But parents of admitted children say they have not noticed any changes so far.
Additionally, the hospital does not provide any provisions for attendants. The attendants either take their meals on the hospital compound pavement, or in corridors. There is no specific living space or area meant for them, as is available in every other government hospital in the city.
Furthermore, if a child from a far flung area is admitted in the hospital, he or she has to spend the night there. A child would most likely be accompanied by parents or relatives. Having no place to rest, they are often seen lying in the corridors of the hospital.
Before the children’s hospital of Hazuribagh was shifted to G B Pant hospital in 2005, the latter was a general hospital managed exclusively by cantonment employees. It would cater only to nearby areas. “It was a well managed and clean hospital then. There was no rush and chaos here,” says Sayeda Khan, a resident of Indira Nagar.
But since 2005, G B Pant hospital is bearing the entire load of a pediatric health care. Patients from as far as Banihal even come here.
It was during Mufti Sayeed’s tenure that the children’s hospital of Lal Ded was shifted to Badami Bagh on a national highway,with the pretext of shifting it to a “better and spacious” place.
The move, however, has become difficult to justify. Ironically, a 175-bed children’s hospital was allotted just 135 beds in the new venue. Although this is 67.5 percent of the total, it is still fewer beds than its previous location.
In this 200-bed hospital, 135 beds are allotted to pediatrics, 35 beds are allotted to gynecology and obstetrics, 20 are given to medicine and 15 to surgery.
However, taking into consideration that admissions in medicine and surgery are not many—and alternatively the patient load in the pediatrics department is high—the hospital’s administration adjusted these 35 bedsin pediatric care, making a total of 170. But this is still short of the five beds that they had inLalDed.
Misnomer And Mismanagement
The Cantonment General Hospital is a multi-specialty hospital usually dubbed as the valley’s lone children hospital, which it is not. The fact is that Kashmir does not have any exclusive pediatric and neonatal hospital.
This multi-specialty hospital carries the maximum load of pediatric and neonatal health care in Kashmir. Although some of the load is shared by Lal Ded hospital and SKIMS, the fact does not change the situation at this particular facility.
Lal Ded hospital, an extension of G B Pant hospital,can cater to at the most 40 neonates at a time,and have the availability of five ventilators, out of which one is presently out of order. They only entertain new borns who have been delivered at their hospital. The SKIMS is a tertiary care hospital that has two ventilators and five incubators for neonates, according to Dr Riyaz Ahmed Rangraiz Shah, the Deputy Medical Superintendent at SKIMS. In the year 2009-2010, it has taken care of 1250 neonatal critically sick patients and around 1300 pediatric patients in 2009-2010.
The cantonment hospital serves most of the pediatric patients in Kashmir, however it has almost the same number of ventilators and warmers as Lal Ded does. “We are definitely in need of more ventilators, as the rush of patients is increasing day by day and for that we have sent a requisition. Let’s see what happens!” says Dr Kaisar Ahmed the Medical Superintendent of G B Pant Cantonment Hospital. They have five ventilators (four for neonates and one for pediatrics), 50 warmers and five photo therapy machines.
On average, the hospital OPD attends to700-800 patients a day, out of which about 70-80 are admitted.“We get patients from all parts of the Valley, even people from parts of Jammu and Ladakh region visit us,”says a senior resident.
G B Pant hospital has only 200 beds, but at any given time, there are about 250 to 280 patients admitted in the hospital. “We cannot deny treatment to any patient. Whoever needs our assistance we have to entertain him, we can’t put an excuse of space before him. Where will he go?” says Dr Kaisar.
Doctors in the hospital blame the weak referral system of the district and sub district hospital for the rush, and the mistrust in those centers. “We at times receive a patient with cold, simple fever or less appetite in our OPD’s from far flung areas. These kinds of ailments can easily be treated at their district and sub district levels, but they are made to travel long distances and add an unnecessary load in this hospital,” says a senior resident posted in the Cantonment hospital.
Doctors believe that patients like these take the time that could be precious for another patient having a relatively more serious ailment. “We have to give equal time an attention to all patients, otherwise they complain. But some need extra care which at times we cannot manage [due to huge rush]”, he adds.
Every district hospital has to be well equipped with some photo therapy machines and warmers meant for neonates. Under National Rural Health Mission (NRHM), they have to maintain a warmer corner in their hospital so that an unhealthy new born does not have to suffer.
The rush in the OPD’s and heavy admissions make maintaining the hospital’s sanitation a difficult task.“I know sanitation is important in a hospital but the rush is so heavy that our own sanitation staff does not suffice. We are planning to outsource this facility like LalDed hospital has done,” says Dr Kaisar.
The hospital administration is planning to privatize the sanitation of the hospital, as they think it has worked in LalDed.
Since 2005, the Government Cantonment hospital has caught the attention of local media, mostly for wrong reasons. Earlier this year, R S Chib, the Minister for Medical Education was quoted as saying that the hospital building is “designed in the wrong way.”
The Health Ministry had proposed a 400-bed pediatric hospital in Bemina, but that was a long time ago—and nothing substantive has come about.